Magnitude and Pattern of Peripheral Neuropathy and Its Association with Disease Duration and Severity in Patients with Chronic Liver Disease: A Hospital-Based Cross-Sectional Study from the Bundelkhand Region

Background: Peripheral neuropathy (PN) is a common but often unrecognised complication of chronic liver disease (CLD). Aims and Objective: To determine the prevalence, type and pattern of PN in CLD and its association with aetiology, duration, Child–Pugh class and fibrosis stage. Materials and Methods: This cross-sectional study included 104 consecutive adults with CLD at a tertiary centre in Jhansi (May 2025–April 2026), excluding other causes of neuropathy. All underwent neurological examination, nerve conduction studies (NCS) and transient elastography. Chi-square tests (Monte Carlo exact test for sparse tables) and multivariable logistic regression were used. Results: The mean age was 44.8 ± 10.3 years; 87.5% were males and alcohol was the commonest aetiology (46.2%). PN was present in 58 patients (55.8%; 95% CI 46.2–64.9); 63.8% were subclinical. Sensorimotor (69.0%) and axonal (69.0%) neuropathy predominated. PN did not differ by aetiology (p=0.91) but increased with CLD duration (20.8% at 1–3 years to 100% at ≥10 years; p<0.001), Child–Pugh class (A 13.6%, B 51.4%, C 78.7%; p<0.001) and fibrosis stage (F2 35.0%, F4 72.0%; p=0.005). On multivariable analysis, CLD duration (aOR 1.55 per year; 95% CI 1.16–2.06) and Child–Pugh class C (aOR 7.60; 95% CI 1.33–43.27) were independently associated with PN, whereas fibrosis stage was not. Conclusion: PN, mostly subclinical, sensorimotor and axonal, was found in over half of patients with CLD and was associated with longer disease duration and hepatic decompensation; no significant association with aetiology was detected in this cohort. Neurological assessment and NCS may be considered, particularly in patients with long-standing CLD or advanced Child–Pugh class.